New Patient Forms

Confidential Patient Medical History: You may complete an On-line Confidential Medical History form here or a pdf version of the form may be downloaded here. Please complete this form before your first clinic visit.

Pediatric Initial Health Questionnaire: You may complete an On-line Pediatric Initial Health Questionnaire form here or a pdf version maybe downloaded here. Please complete this form before your child's first clinic visit.

Authorization for Disclosure of Medical Information: A pdf version of an Authorization for Disclosure of Medical Information form may be downloaded here. This form may be used to have your records transferred from another medical care provider to FamilyHealth Medical Clinic. Please fill it out, sign it, and submit it to your previous provider.

Living Will

Health Care Directive: A pdf version of a Health Care Directive form may be downloaded here.

Cardiac Stress Tests

To help you learn what to expect from your cardiac stress test, please download one of the pdf files below:

Cardiac Stress Test (Basic Exercise Walking Test)

Dobutamine-Echocardiogram (Non-walking Stress Test)

Exercise Myoview Perfusion (Walking Cardiolyte)

Adenosine Myoview (Non-walking Stress Test)

Stress Echocardiography (Walking Exercise Test with Echocardiogram)

Diagnostic Imaging

The following brochures provide answers to frequently asked questions about common diagnostic imaging procedures.
They may be downloaded in pdf format.

Diagnostic Ultrasound

Nuclear Medicine Testing

CT Scanning

MRI Scanning

Upper GI Series

Small Bowel Follow-Through

Modified Barium Swallow or Esophagram

Intravenous Pyelogram

Barium Enema and Air Contrast Barium Enema